Individual
MRS. KATHY M DIETLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
49 STATE ROAD, WATUPPA BUILDING SUITE 203, NORTH DARTMOUTH, MA 02747-3300
(508) 994-0120
(508) 996-9636
Mailing address
49 STATE ROAD, WATUPPA BUILDING SUITE 203, NORTH DARTMOUTH, MA 02747-3300
(508) 994-0120
(508) 996-9636
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
78175
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3118061
—
MA
Enumeration date
03/18/2006
Last updated
10/07/2022
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